Provider Demographics
NPI:1578616934
Name:DAQUIOAG, ELEANOR P (MD)
Entity Type:Individual
Prefix:DR
First Name:ELEANOR
Middle Name:P
Last Name:DAQUIOAG
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2101 EAST JEFFERSON STREET
Mailing Address - Street 2:KAISER PERMANENTE, PPQA, 6 WEST, ATTN: THERESA BROOKS
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:301-816-6660
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:1011 NORTH CAPITAL STREET
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002
Practice Address - Country:US
Practice Address - Phone:202-898-5104
Practice Address - Fax:202-898-5474
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD17672207RN0300X
MDD0037814207RN0300X
VA0101043235207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
098386M92Medicare ID - Type Unspecified
E30499Medicare UPIN